Request for Approval

0920-0900_Non-sub change request_10.04.21.docx

Contact Investigation Outcome Reporting Forms

Request for Approval

OMB: 0920-0900

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OMB Control Number 0920-0900: Contact Investigation Outcome Reporting Forms


Non-Substantive Change Request


Expiration: 08/31/2024




Program Contact: Colleen Brouillette, mfi3@cdc.gov




Submission Date: October 4, 2021



Justification for Change Request


This is a nonmaterial/non-substantive change request for OMB No. 0920-0900, expiration date 08/31/2024. All requested changes represent minor modifications to already-approved instruments including revised formatting, rewording, new answer options, and the addition/subtraction of a limited number of questions.


This non-substantive change request is for the option to fax the form to be removed from Attachments G, H, I, and J. Email will be the only option for submission and the forms will be fillable pdfs. For Attachment K, the word “Immunity” in section five will be changed to “Vaccination,” which is the accurate term. The term “Immunity” is inaccurate to use for that section.


None of these changes will change the burden hours for respondents.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleOMB CY 08
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File Modified0000-00-00
File Created2021-11-03

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